Talk:Haloperidol/Archive 1
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Untitled
Now, the article on Haloperidol has been completely revised and extended. Please check carefully for errors and communicate them. Thanks for your help!
See Pharmacology
Haloperidol is a antipsychotic and a butyrophenone. Due to its strong central antidopaminergic action, it is classified as a highly potent neuroleptic. It is approximately 50 times more potent than chlorpromazine (sold under the brand name Thorazine, among others)
Note: Thorazine should NOT be confused with the Drug Name Thioridazine. See http://en.wikipedia.org/wiki/Thioridazine Sorry I dont know how to edit Wiki and Include the same warning on the page quoted above and this easy mistake in Drug Name and Brand Name confusion!!60.241.46.128 (talk) 01:02, 30 June 2010 (UTC)
See also
Ombudsman (talk · contribs) inserted a few articles for "see also": Biological psychiatry, New Freedom Commission on Mental Health, Psychiatric survivors movement.
I removed these links because they do not relate directly to haloperidol. Ombudsman reinserted them with the edit comment: "restore see also section; haldol has been central to the arsenal of 'treatments' used against persons labeled w/ pseudoscientific 'diagnoses'; article is an example of whitewashing"[1].
Ombudsman has a history of pushing his POV by inserting "see also"s to articles with content have he favours. The edit summary reveals the antipsychiatry POV. I encourage Ombudsman to improve this page with NPOV content, such as substantiation of the assertion that this article is "whitewashing" and a source for the assertion that psychiatric diagnoses are "pseudoscientific". JFW | T@lk 14:33, 28 December 2005 (UTC)
contradiction
It seems like 'devoid of any psychological dependence' and 'rebound into mania' are contradictions, unless there is a clear defined, referenced differentiation between their 'physical' and 'psychological' sources. Clarification? —The preceding unsigned comment was added by 168.105.118.109 (talk • contribs) .
- I think, when looked at informally, the intent of the two terms is fairly obvious: Haloperidol is not 'addictive' in the colloquial sense (not in the way that benzodiazepines are), but may cause clinical deterioration upon abrupt cessation. Perhaps the language could be cleaned up a bit, though. --Bk0 (Talk) 17:48, 7 February 2006 (UTC)
Rebound is being used incorrectly. The term here is more appropriately "relapse." Rebound is a rapid onset of symptoms due to the abrupt discontinuation of a drug. Relapse is the re-emergence of underlying disease due to lapse of treatment. Patients may relapse into psychosis or acute mania if anti-psychotic medication is withdrawn.
There seems to be another contradiction within the artical, it supposedly states that this drug will surpress hullciations caused by PCP, however i was under the impression that PCP was a dissasociative drug and therefore Haloperidol would be uneffective, however I am not an expert and therefore did not feel i had the right to change anything.
anticholinergic effects
I will review this topic further before making any changes, but I am fairly sure that hypertension, as opposed to hypotension would result from the use of anticholinergic agents. —Preceding unsigned comment added by Afromcbenny (talk • contribs) 07:14, 16 February 2008 (UTC)
Breast feeding
Very good article. Perhaps it would be useful to provide some additional information on the use of haloperidol in lactating mothers. The authoritative website http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~ox1B0U:1 comments: "...Limited information indicates that maternal doses of haloperidol up to 10 mg/day produce low levels in milk and do not affect the breastfed infant. Very limited long-term follow-up data indicate no adverse developmental effects when haloperidol is used alone. However, combinations of antipsychotic agents can negatively affect development. Monitor the infant for developmental milestones, especially if other antipsychotics are used concurrently."
Since the dose used seems to clearly influence the degree of potential effects, this issue warrants discussion, in my opinion.
Thank you,
146.155.244.174 15:40, 13 September 2006 (UTC)
== Diabetes == I have received Haldol for 30 years and recently have come down with Diabetes. Initialy I recieved Haldol suposotories at a County Hospital to calm me down. After the initial dose did not stop my from screaming and complaining about my treatment at the hands of the hospital workers another dose was administered. Haldol does nothing it proports to do. I can think logically when I want to and I can have sureal imaginations whenever. If it bugs you too bad. The Haldol does not stop me from being illogicall and as creative as I wish. Psychobable is a very dumb language to me and I get angry at having to speak it to shrinks. I wish these professionals would find a more usefull way to contribute to society other than trying to modify other people's different behavior. —Preceding unsigned comment added by 206.170.111.187 (talk) 00:30, 6 August 2009 (UTC)
Yellow phlegm
I removed the discussion of yellow phlegm [2]. I'm not aware of yellow phlegm as being a mechanism of elimination for haloperidol, as it is metabolized in the liver and eliminated in the urine and stool. Andrew73 14:51, 6 June 2007 (UTC)
Fork to Haloperidol - Adverse Effects
I've removed this fork, as it the content is already covered in the main article. Andrew73 14:53, 6 June 2007 (UTC)
Sources?
Oddly enough, this article is completely without references for all the information presented. As far as I can see, this could all be nonsense. Actually, I'm mistaken, the article has 3 citations to sources in German.. this is unacceptable for an english Wiki entry.. please review Verifiability. I'm going to put an unreferenced tag on it, perhaps someone can solve this issue. Not that I have any qualms with the information, but it is effectively useless unsourced.
- its an article mainly taliored by the pharma Janssen or else Johnson & Johnson, and maintained by them or their interests, and a few shrinks they pay or that are on their side. and i actually put in the referenced link to this drug used to torture political dissidents, which is true, and it was the only thing referenced in this article just about, but they removed it of course!!!!! i also put linked stuff from a harvard physician about this drug, that has a negative opinion, fully referenced, and that was removed too, but they dont remove the unreferenced drug company info!!! 129.194.8.73 (talk) 15:30, 14 February 2008 (UTC)
Torture, Punishment, Interrogation
well i have added one to anna politkovskayas book, as u begin to see this is not quite what y'all thought it was...reports are now coming in from europe and the united states as to incidents as well in those areas —Preceding unsigned comment added by 83.79.143.64 (talk • contribs) 00:51, 24 December 2007
- Your edits reverted, not least for being too eager and so edits become silly or uncoinstructive. As examples:
- Stating drug "was used in the 20th and 21st centuries on planet earth" - we can assume for all drugs that default is planet Earth rather than Zog.
- You delete out unreferenced point that used "for treating psychiatric emergency situations" which is true that it is generally so considered useful. Yet your ediut makes wild claim for misuse of the drug by many countries, yet only single source given for its use in Russia.
- The example given of "given by the soviet regime to Russian dissenters of the 1968 suppression of the Czech uprising" would only only support abuse with this drug in the 20th centurary rather than "the 20th and 21st centuries".
- Please no not make legal threats as per this edit summary
- David Ruben Talk 04:52, 24 December 2007 (UTC)
the legal references are not to wikipedia users, they are to researchers and physicians that might be involved in malpractice and incompetence lawsuits, although it is certainly a possibility that wikipedia editors may be invoved in a lawsuit over this one, yet their anonymity makes that unlikely, but anyways thats not at all what was meant, it was denoting, and not on the page, but on the editting notes, that lawsuits have been filed over this drug and giving editors a heads up to that, and that researchers and physicians defending it may be involved in suits, and actually is encouraging wikipedia editors to start assembling the notes from the scientific research as to who exactly is saying what about this compound, to put them on the record so everyone can see who they are and what their names are!
as to it, "was used in the 20th and 21st centuries on planet earth", well thats entirely factual, some people when writing encyclopedias think in terms of the bigger picture, and have a realization at this point multiple planets are in the picture for people, and that earth is just one of their planets, and also putting this matter in perspective for future readers, its time to realize that the 21st century was one of colonization off of planet earth, with hundreds of people now sent into space, multiple plans from many lands to settle and put bases on planets, multiple installations in space, hordes of sattelites, multiple rovers & "other vehicles" now exploring and doing geological research on other planets, i suppose some editors are looking further ahead than others and anticipate future edits that will undoubtedly say "haldol was used in the 20th and 21st centuries on planet earth", and this looking ahead eliminates wasted edits. And yes one could look much further ahead, but im just coming at it with a 21st century perspective, obviouly if u read that sentence its from an educated present perspective
anyways everything in this article is entirely unreferenced, it could all be deleted on those grounds, except for this part about its use as a torture, interrogation, and punishment device, which is factual and documented and referenced, the rest is unreferenced and reads like an advertisement for a pharmaceutical company, i will leave it for now, but encourage wikipedia editors to start assembling the names of who said these things about it, lets get them and their names on the record, i may start a policy of deleting sentence by sentence, so someone has to come in and reference it to who from the research advocates whichever particular fact, wikipedia is an anonymous tool so editors themselves are safeguarded against lawsuits, and anyways no threat was made to editors so there is no need to get paranoid about it83.79.143.64 (talk) 11:25, 24 December 2007 (UTC)
use in torture
as to a deletion of something, that it seems has some refs, well i may put it back in, i just noticed its referenced to a few things, but im somewhat sceptical with the summarization from source "The controversy over "chemical restraint" in acute care psychiatry" then leading to a wikipedia paraphrase of "Haloperidol was considered indispensable for treating psychiatric emergency situations" —Preceding unsigned comment added by 83.78.141.149 (talk) 15:56, 25 December 2007 (UTC)
- These edits constitute a third revert in just over 24hrs. They are poorly phrased and 83.78.141.149 (talk · contribs) justification for galaxy-wide future-proofed style is both daft and detracts from what might be a valid points about the drug being misused. So problems with the edits:
- "Haloperidol was used in the 20th and 21st centuries", the ref given is for actions in 1968, that is not the 21st Century.
- "by several countries", yet the single ref given applies only to Russia
- citation details for Cochrane Database of Systematic Reviews - the reference details are as given by PubMed using standard abbreviation for the journal name, and had given a link to the full paper, yet this is repeatedly reverted to just web link to the abstract - this diminishing of access to full reference is therefore being disruptive.
- Repeated removing of role of Haloperiodol in emergencies - ref provided confirms both that it was felt useful drug and that the number one drug advocated for such a role back in 1986. Since various consensus statements on its role have shown a decline in its role with newer drugs perhaps taking prime position. To repeatedly delete this because of your own personal views against this drug, therefore is in breach of WP:NPOV.
- Your deletions have left the comment re WHO status as an indented text box.
- "Opponents, Toxicity, Nerve Damage " section is a minority viewpoint and not one held by majority of medical community. As such WP:UNDUE applies in not promoting a minority viewpoint. Indeed I suspect the number of psychiatrists who are likewise so opposed to this drug may well be so small as to constitute a trivial minority and one "should not give minority views as much or as detailed a description as more popular views, and may not include tiny-minority views at all"(WP:WEIGHT)
- "Use as a Human Torture Device" - where to begin ? As per previous thread postings, wikipedia may safely be assumed to apply to humans and we need not concern ourselves with post-humans or aliens having to later understand an ancient text, it is not accepted as inevitably being a torture (vs say thumbscrew) although of course it is open to misuse, and finally it is not a device but a medicine.
- Anna Politkovskaya ref is given as a footnote in the leadin, to then also use as a reference for the whole article just seems further example of POV pushing on this point.
- I try to personally follow WP:1RR, so will step back for now to allow others to consider the repeated edits and my above & previous points raised. David Ruben Talk 20:45, 25 December 2007 (UTC)
- No objections or points raised by other editors re above for 3 days now since another admin semiprotected page re "Protected Haloperidol: Edit-warring and POV-pushing, dynamic IP". So I've been bold and reverted article to Casliber's. David Ruben Talk 12:52, 28 December 2007 (UTC)
Not outperformed in the treatment of positive symptoms by 2nd gen? Source?
"The effectiveness of haloperidol against positive symptoms has not been outperformed by newer antipsychotics."
Well, well. This should be sourced. Though therapeutic superiority in psychopharmacology is in general hard to prove, in my experience, clozapine specifically would be a good candidate to outperform haloperidol in antipsychotic effectiveness, even in positive symptoms.--84.163.105.77 (talk) 02:50, 14 January 2008 (UTC)
- Good pickup - Yes I agree, I think what it is meant to say is clozapine best and all others more or less as effective as each other. Will get to it later. cheers, Casliber (talk · contribs) 03:52, 14 January 2008 (UTC)
Haloperidol in Putin's Russia
I searched for "haloperidol" and "haldol" inside the book Putin's Russia using Google and found no hits. So I remove the sentence puprportedly based on that book. Per WP guidelines to show the citation is real, if you want to restore it, I ask you to quote here a full paragraph mentioning haloperidol. Paul Gene (talk) 11:49, 20 February 2008 (UTC)
- That is because they don't call it Haloperidol or Haldol in Russia most likely. For instance in the Philippines Haldol is called Halobera not Haldol. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 04:05, 21 May 2013 (UTC)
the book is not online, go to a major bookstore, grab the book, i told u the pages, and it is written clearly in it, i have seen the book, and read that part, until u check and find otherwise, u cant delete based on a "google search", books are not entered into the internet! u have to look at the book itself
i am restoring, and i will also do as u say, and when i get a chance here today or tomorrow, ill also add several quoted lines concerning this drug from that book to expand this further beyond what i have written!!! in fact mrs politkovskaya mentions several accounts, more than one, of situations where this drug was used to torture 129.132.128.136 (talk) 16:27, 21 February 2008 (UTC)
- If you want to add descriptions from "high-functioning patients" of what it feels like to be on haldol, you need not use extremist or self-published sources. You can go to the peer-reviewed literature on Tourette syndrome. If that book can't even spell tics correctly, that's a concern. If you want to add this info about Haldol, please base it on reliable sources: there are plenty of credible accounts of what Haldol feels like from the TS literature. Please use reliable sources. SandyGeorgia (Talk) 17:41, 21 February 2008 (UTC)
For example, discussion of the intolerable side effects for most people using haldol, even at low doses, can be found at:
- Leckman JF, Cohen DJ. Tourette's Syndrome—Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. John Wiley & Sons, Inc., New York, 1999. ISBN 0-471-16037-7 Outline. Retrieved on 28 October 2006. pp. 374–375. (Cohen, deceased, was the former director of the Yale Child Study Center and, together with Leckman, the pair are the foremost publishers and researchers on TS.)
- 2006.
- Robertson MM. "Tourette syndrome, associated conditions and the complexities of treatment" (PDF). Brain. 2000;123 Pt 3:425–62. PMID 10686169 Retrieved on 25 January 2007 pp. 436–438 include a discussion of 16 side effects of neuroleptics.
There is no need to resort to sources like Breggin or other obscure publications. SandyGeorgia (Talk) 18:01, 21 February 2008 (UTC)
- Why not use Breggin? He is controversial, of course, but that is no reason to avoid him. Most of the time I found good references on his site. So why avoid him? Nopedia (talk) 20:29, 26 December 2012 (UTC)
- Likewise, if you want to read an interesting narrative, anecdotal description of the tradeoffs involved in using Haldol for Tourette's, Oliver Sacks has a story entitled "Witty Ticcy Ray", (or something along those lines - it's been awhile). Probably not appropriate for this article, but interesting reading. MastCell Talk 18:18, 21 February 2008 (UTC)
- I don't think Oliver Sacks' ramblings about TS are appropriate anywhere except his own article. SandyGeorgia (Talk) 18:29, 21 February 2008 (UTC)
- Sure, fair enough. Apologies for getting off-topic. MastCell Talk 18:35, 21 February 2008 (UTC)
- That's OK, you can ignore my pet peeves. Anyway, the story of Ray the drummer is in The Man Who Mistook His Wife for a Hat I believe, but Sacks tends to enjoy writing about the extreme, uncommon, sensational and comorbids rather than TS. Remember, we're trying to get away from sources like Breggin. SandyGeorgia (Talk) 18:41, 21 February 2008 (UTC)
- Sure, fair enough. Apologies for getting off-topic. MastCell Talk 18:35, 21 February 2008 (UTC)
- I don't think Oliver Sacks' ramblings about TS are appropriate anywhere except his own article. SandyGeorgia (Talk) 18:29, 21 February 2008 (UTC)
- its not an "extremist" source im gonna use, im using a source from journalist with these awards
* 2001: Prize of the Russian Union of Journalists * 2001: Amnesty International Global Award for Human Rights Journalism * 2002: PEN American Center Freedom to Write Award * 2002: International Women's Media Foundation Courage in Journalism Award * 2003: Lettre Ulysses Award * 2003: Hermann Kesten Medal * 2004: Olof Palme Prize (shared with Lyudmila Alekseyeva and Sergei Kovalev) * 2005: Prize for the Freedom and Future of the Media * 2006: International Journalism Award named after Tiziano Terzani * 2007: UNESCO/Guillermo Cano World Press Freedom Prize (awarded posthumously for the first time)[62] * 2007: National Press Club/John Aubuchon Freedom of the Press Award (posthumous) * 2007 Democracy Award to Spotlight Press Freedom by the National Endowment for Democracy, [4]
is that extremist??? no this is used to torture peopel with, she writes it clearly... and as requested per talk page, i just went to major book store, and copied some phrases from her book, i'm not sure how much longer y'all can keep trying to keep this out, but its all true, haloperidol is used to torture with, and so now i'll go further as "paul gene" requested, and put some excerpts too, i guess in a whole new section too, as im not just after info about what this drug/nerve poison feels like, no we also should include info about its use to torture people with too... and so i add more and not just my paraphrase as before! 129.132.128.136 (talk) 19:08, 21 February 2008 (UTC)
- Well, perhaps you can find some article about Putin's methods of torture in Russia and add it there. Sacks has awards, too; that doesn't make him a credible source of medical information via his fictional books. SandyGeorgia (Talk) 19:10, 21 February 2008 (UTC)
its not Putin that uses this, the russians used this in 1960s 1970s...maybe 80s...the book is documentary book...and by the way, i feel something nasty from some of these editors, something dirty, something unpleasant, that keep trying to block this info for the people... but i'll leave it at that, so go ahead...keep trying to find excuses to block it out, lets get y'all on record 129.132.128.136 (talk) 19:12, 21 February 2008 (UTC)
- I support this info being added to the article. You have won a friend in me. But it is 2008 when you posted this and I am posting in 2013 so maybe you are not still around. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 01:05, 22 May 2013 (UTC)
- As I already said above, if you want to discuss serious adverse affects associated with the legitimate use of Haldol, that can be done with/from the reliable sources I gave you. I'm not trying to keep that info out; on the contrary, I've given you good sources for it. Perhaps you're looking for an article on Russian torture methods or something else. In a medical article, when we have scholarly sources describing adverse effects, we don't need to use journalist sources related to improper use of medications. SandyGeorgia (Talk) 19:18, 21 February 2008 (UTC)
- (ec) Try Punitive psychiatry in the Soviet Union. The next inappropriate post here - meaning ones that involve personal attacks, implications of sinister motives, and a general focus on editors rather than content - is going to be removed and your IP blocked temporarily. MastCell Talk 19:25, 21 February 2008 (UTC)
I, personally, was tortured by the deconate within the U.S. .... And, the deconate was not given to me because of "noncompliance" of any sort. This drug is akkin to "chemical shock" treatment and should be banned within the U.S.. The fact that some psychiatrists are still using it brings into question the effectiveness of the whole profession. This drug is a deniable method of torture and should be controlled with stricter regulations then cocaine. The temptation for bad people to use this drug in order to mimic Parkinsons Disease is too great to just plainly ignore. I know I can't say these things on the front page of this article. The fact that it took until 1984 to legalize its use within the U.S. because of side effects should tip people off just how dangerous this drug is. It would be more properly classified as a poison. If you are a medical professional considering the use of this drug I would like you to remember "Do no harm". Not to mention its use for torture at all, is criminally negligent since I myself was tortured with it here, within the U.S., for three years 24/7. But, since it was done in a deniable manner, I will never obtain the justice that torture deserves. Please.. please.. include the fact that it has been used in that manner somehow. Thank you. Planet Ceres 69.151.28.45 (talk) 17:33, 6 May 2008 (UTC) This drug is the Auschwitz of the mentally ill. And yet, this article reads like it was supplied by drug companies. This is the shame of Wikipedia 69.151.28.45 (talk) 18:23, 6 May 2008 (UTC)
I agree with that completely "chemical shock" is right Haloperidol is a nasty disabling drug; the worst of all the antipsychotics. It is the elephant gun of the pharmacy. It disables so fast and so effectively that the only thing the recipient can do after administration is drool. To say it's an "essential medicine" is only true in it's instant and thereon disabling capacity. —Preceding unsigned comment added by 92.2.118.231 (talk) 02:05, 13 August 2008 (UTC)
- Ignoring the above. We designate haloperidol as an essential medicine simply because the World Health Organization does so. We don't engage in original research, let alone publish personal accounts.LeadSongDog come howl! 16:40, 14 September 2010 (UTC)
I support the info being added to the article. I hope you are still around to add it back in because I will defend its inclusion. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 01:11, 22 May 2013 (UTC)
dates
18 September 2008
1988 as the date haloperidol was introduced must be a typo as I recall using it in the 1970's
Jonathan W. Stewart, M.D. —Preceding unsigned comment added by 208.120.149.164 (talk) 11:15, 18 September 2008 (UTC)
Clarification needed under Overdose Prognosis section
"Generally, the prognosis of overdose is good and lasting damage is not known, provided that the patient has survived the initial phase."
Does this mean it is not known whether there will be lasting damage or does it mean that lasting damage is not known to occur at all? Needs to be clarified please. —Preceding unsigned comment added by 69.214.1.37 (talk) 16:24, 19 October 2009 (UTC)
Plasma levels seems high
This information seems old and outdated. Citations please. Nopedia (talk) 01:09, 25 May 2011 (UTC)
Does Haldol antagonize Epinephrine and Norepinephrine additionally?
Almost every neuroleptic antagonizes the alpha adrenoreceptors. Is there any proof this medication inhibits the alpha adrenrgic receptors as well? — Preceding unsigned comment added by 00AgentBond93 (talk • contribs) 20:22, 29 June 2012 (UTC)
Synthesis
There needs to be a section on how this drug is synthesised. 2602:306:C518:62C0:5C06:758E:E477:60D6 (talk) 23:12, 31 July 2012 (UTC)
http://www.drugsyn.org/Haloperidol.htm — Preceding unsigned comment added by 2602:306:C518:6C40:61B1:B9B8:E848:31A7 (talk) 01:08, 13 May 2013 (UTC)
Someone should lift the synthesis information for the medicines listed on this site and add them to the articles with attribution. 2602:306:C518:6C40:61B1:B9B8:E848:31A7 (talk) 02:11, 13 May 2013 (UTC)
Conditions:-
i. Fluorobenzene, aluminum chloride, carbon disulfide, room temperature, 2 h, ii. 4-(p-chlorophenyl)piperadine-4-ol, potassium iodide, toluene, 100 - 110 ºC
Preparation of Haloperidol is described in US patent 3,438,991, GB895309 and BE577977. Accordingly, 4-chlorobutanoyl chloride 1 was reacted with fluorobenzene in presence of aluminum chloride using carbon disulfide as solvent at ambient temperatures to give 4-chloro-1-(4-fluorophenyl)butan-1-one 2. Heating 2 with 4-(p-chlorophenyl)piperadine-4-ol in presence of potassium iodide as catalyst and toluene as solvent affords [[4-[4-(4-chlorophenyl)-4-hydroxy-1-piperidyl]-1-(4-fluorophenyl)butan-1-one]] also called Haloperidol 3.
Haldol is clearly a wicked poison. It consists of petrochemical derivatives fluorobenzene, chlorobenzene, butanone and the fire ant venom piperdine. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 04:25, 20 May 2013 (UTC)
- You seem to have very little (less than nil) knowledge of chemistry. Haloperidol does consist of haloperidol, which is a single pure substance. To say it consists of fluorobenzene, chlorobenzene, butanone and piperidine is like saying a person consists of earth, manure (used to fertilize the soil), wheat seeds, rainwater, sunlight, diesel oil for the harvesting machine, a little salt, egg yolk, spices, corn oil and natural gas used to cook the meal properly. Its nonsene, sorry.--149.172.140.151 (talk) 02:18, 18 June 2013 (UTC)
Pharmacology section (edited and revised on August 5, 2012)
Great job minimizing the crap info. I think typing in the receptor affinities makes it easier for other Wikipedians to read. — Preceding unsigned comment added by 00AgentBond93 (talk • contribs) 19:05, 5 August 2012 (UTC)
Increased mortality
I just read this in JournalWatch, as part of their year's roundup of important stories:
http://psychiatry.jwatch.org/cgi/content/full/2012/206/3
Antipsychotics Vary in Mortality Risk in Dementia Patients
Haloperidol had the highest 6-month mortality rate; quetiapine, the lowest.
Behavioral symptoms in dementia are often treated with antipsychotics, but increased risks for mortality have been associated with such treatment. Using retrospective cohort data from national Veterans Affairs registries, researchers in a study supported by the National Institute of Mental Health compared 6-month mortality rates in 33,604 patients aged 65 or older with dementia who were started as outpatients on one of three antipsychotics or one non-antipsychotic (after ≥1 year without antipsychotics or anticonvulsants).
Compared to mortality risk with risperidone, mortality risk increased significantly with haloperidol (hazard ratio, 1.54); was statistically similar with olanzapine and with valproic acid and its derivatives; and was significantly lower with quetiapine (HR, 0.73). Patients taking haloperidol were more likely than others to have been older, sicker, and black; to have had concurrent delirium and more inpatient days; and to have taken opioids or benzodiazepines in the previous year. However, findings were similar in analyses controlling for these factors and for site and medication doses. Differences in mortality risk were greatest for haloperidol during the first 30 days of treatment and for the others during the first 120 days. The crude death rates for exposure to haloperidol, risperidone, and quetiapine were 45.8, 27.1, and 18.6 per 100 person-years, respectively.
Here's the original source:
Kales HC et al. Risk of mortality among individual antipsychotics in patients with dementia. Am J Psychiatry 2012 Jan; 169:71.
--Nbauman (talk) 17:32, 10 January 2013 (UTC)
- Interesting article and might be prudent to discuss, however it is not a Review article but a cohort study. Delirium itself has a high mortality so I wonder if they accounted for that in calculating (I doubt it as it was a retrospective cohort study).....anyway, worth looking into more detail but I'd need a Review before adding...Casliber (talk · contribs) 00:06, 11 January 2013 (UTC)
Dosages?
Since when do we have dosage information in articles? Is there a special reason for having them in this article? LeadSongDog come howl! 17:35, 6 February 2013 (UTC)
True Use of Haldol in the USA
Not directed to improving article. Collapsed.--Garrondo (talk) 06:53, 21 May 2013 (UTC)
Butanone causes Birth Defects and is part of the molecular structure of Haldol
The psychiatry book for "diagnosis" lists "strange ears" as a sign of schizophrenia to cover up the birth defects caused by the Butanone in Haldol. I have been given Haldol repeatedly in my life off and on and my son has weird ears because of the Butanone in this drug called Haldol. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 18:51, 22 May 2013 (UTC)
- You are completely mistaken. The fact that wording similar to "butanone" may appear in the middle of the systematic name of haloperidol has no bearing whatsoever on whether there is similarity in chemical or physical properties of the two molecules. There is no butanone in haloperidol. If you are not able to understand that, then you should not be making chemistry-related, particularly chemical-nomenclature-related, edits to Wikipedia. ChemNerd (talk) 19:19, 22 May 2013 (UTC)
Butanone itself may not be a precursor to Haldol in its synthesis but the Butanone structure does indeed exist in the structure of the Haldol Molecule. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 19:32, 22 May 2013 (UTC)
- No, the structure of butanone does not exist in the structure of haloperidol. It is a quirk of chemical nomenclature rules. The atoms are arranged differently. And the substitution on the four carbon chain rules out any connection in terms of chemical or physical properties of the two chemical structures. ChemNerd (talk) 19:44, 22 May 2013 (UTC)
You are just angry that I can see clearly. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 19:48, 22 May 2013 (UTC)
ChemNerd anybody with eyes can see Butanone is part of the molecular structure of Haldol molecule attached to the Fluorobenzene. 2602:306:C518:6C40:F02A:330C:11CC:ACDB (talk) 20:14, 22 May 2013 (UTC)
- It is on you the weight to bring sources saying that haloperidol causes birth defects caused by the Butanone in it. Similarly you should bring a source saying that the simmilarity of haloperido with butatone you propose has any consequences. Your aggresive tone, and strong (if not biased) point of view does not help you either.--Garrondo (talk) 20:37, 22 May 2013 (UTC)
- Yes references are needed to back up your statements. Without them not much will change. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:49, 23 May 2013 (UTC)
- The structural molecular motif in haloperidol is butyrophenone, which is different from butanone (methylethylketone; butan-2-one). It is, simply said, a substance which can be derived by an electrophilic reaction of a butyric acid derivative with a benzene derivative. Beside that, there is no robust evidence for teratogenicity of haloperidol. Quite to the contrary, haloperidol (and very few, mostly old, antipsychotics) are considered to be relatively safe in pregnancy, for the mother as well as the unborn, should an antipsychotic or neuroleptic/antiemetic medication be absolutely necessary. In a number of countries in Europe (thus in a big patient population, some of which were preganant women, inevitably), haloperidol was available as early as 1961. Back at the time, regulations concerning medication in pregnancy were far less restrictive then today; it thus happend that a lot of pregnant women who emergently needed a neuroleptic medication became Haldol in the 1960s, and they gave births mostly to healthy newborns. Nothing grossly teratogenic, no thalidomide or the like. It was quite a gambit then, but thanks to this circumstance, the medical science today has data which cannot be collected in a double-blind trial in accordance with the ethic of today's medicine (to double-blindly dose pregnant women with a new potential drug would carry an unnaceptable risk of the potential drug turning out teratogenic in the end. No sane person would do that). Cheers,--149.172.140.151 (talk) 02:12, 18 June 2013 (UTC)
3D Animated Molecule Picture Request for Lurasidone
http://en.wikipedia.org/wiki/Lurasidone
Someone with the ability to make 3D and especially animated like the Haldol one here pictures of the molecule should make one for Lurasidone. 2602:306:C518:6C40:505A:5C79:DCDB:627E (talk) 23:47, 25 May 2013 (UTC)
Added in amiodarone interaction
Was personally unaware of this interaction until my father was placed on haloperidol and both doctor and pharmacist directed removal of amiodarone from his medications. Came here, found nothing, so I looked it up and added a NIH link as a citation. Cite or die!Wzrd1 (talk) 05:27, 15 October 2013 (UTC)
Removal of unsourced statement
The following (unsourced) statement appears in the article's lead:
“In some countries, such as the United States of America, injections of antipsychotics such as haloperidol can be ordered by a court at the request of a psychiatrist.”
This is quite a serious statement, and I've tried to find a source that supports it, but came up empty. Before I go ahead and remove it, I thought I'd ask if anyone else is able to provide a source that supports it. I'll give it a couple of days, and if nobody is able to provide something to support it, I'll go ahead and remove it. --Schaea (talk) 11:09, 18 December 2013 (UTC)
- Done. Statement removed from article. --Schaea (talk) 23:20, 21 December 2013 (UTC)
"Marginally effective"
The article states that haloperidol is "marginally effective." It cites a source that does not make this claim. In fact, any expert and many patients can tell you that this is not the case. Also, the article goes on to say that the citation "may be overly generous," which is a very subjective claim. Then it says that haloperidol "should only be used if other treatments are not a possibility" - this is also not specifically stated in the article, and is not consistent with the clinical opinion of most experts. I think it's unwise to be giving medical advice like this.
In fact, haloperidol is a very effective drug, as would be clear if you search the overall literature or talk to most experts. It does cause some adverse effects, but is no more unsafe than other drugs used to treat schizophrenia - in fact, it is probably one of the safer drugs available in its class. Many of the studies that tested haloperidol are old studies that used excessively high doses, which are no longer used.
I tried to remove that paragraph because it was so biased and drew inappropriate conclusions based on the literature. I'm sorry if I didn't follow the etiquette correctly - I don't do this very often, but I could not leave this particular piece of information because it was such an egregious threat to the safety and health of my patients. It's so misleading that I can only suspect that it was written by one of the drug companies that produces a rival drug (since haloperidol costs $4 and many of the newer competitors cost thousands) or by an uninformed individual who unfortunately suffers from a serious mental illness and is currently off his/her medications. — Preceding unsigned comment added by Shan564 (talk • contribs) 19:49, 16 February 2014 (UTC)
- Considering your removal was reverted, then reinstated, then reverted again, then you reverted the content again, perhaps you should discuss it here first and gain consensus. I have no access to the cited articles, hence can give no input on their content. I can, however, speak to the removal of the section and its impact on the citation section, which is now broken due to a citation being present but unreferenced in the article for Coch2006. I'll conditionally agree in regards to subjective claims. Such claims should only be rarely used and then based upon quotations of a citation. Efficacy of the drug is relative and discussion in the article or here should also have citations. As for your theorized justification for the "offending" paragraph, you perceive a rationale that may or may not be present. One should assume honest intentions in preference to either financial gain or mental illness. This is especially true when discussing articles on psychiatric medications and to be honest, it's been my experience that patients "off his or her medications" tend to display more fixation, use my hyperbole or generally use phrases that make it readily apparent that there is a goal seeking in operation that is far afield from the purpose of the article. What is of impact here is that you are toying around near the three reversion number, one that can result in the claim of an edit war. Can we have an editor weigh in that is conversant with the questioned content and the citations in it?Wzrd1 (talk) 20:23, 16 February 2014 (UTC)
- Can you provide a better reference that properly documents your assertions, that complies with WP:MEDRS? The removal/reinstatement, etc. was my mistake: I wanted to leave an edit summary so that my reversion of what appeared to be a good-faith removal might be more clear. Acroterion (talk) 20:26, 16 February 2014 (UTC)